Provider Demographics
NPI:1306220769
Name:WOOD, MEREDITH HOWARD (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:HOWARD
Last Name:WOOD
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S PETERS RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5204
Mailing Address - Country:US
Mailing Address - Phone:865-314-5939
Mailing Address - Fax:865-693-7454
Practice Address - Street 1:9047 EXECUTIVE PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4625
Practice Address - Country:US
Practice Address - Phone:865-314-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3853101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health